Roving dermatologists on speed dial to diagnose skin problems - Sacramento Business Journal:

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The program involves arming a dermatologist at each Kaiser site in the area with a mobile phone to answe r calls from primary care doctors with patientzs that display suspect molewor non-obvious skin rashes. The rovinyg dermatologists canprovide same-day assessments and biopsies of skin saving patients the month-long wait it otherwise can take to get an appointmenyt with a dermatologist. “I get on the and within five minutes they show up in my exam said Dr. Thomas Connolly, a Kaiser internis t and associate physician in chief with theDiablo region, whicu includes clinics in Pleasanton, Walnut Creek, Martinez and Antioch.
“Frequently, the time betweehn hitting primary care physicia and biopsy is a matter of hourse instead of a monthor Kaiser’s approach in the Diablo area is a hit with primart care doctors such as Connolly, who says the programm is alleviating a long-standing problem at Kaiser. The roving doctor concept, which started in Pleasanton and is now beingy employed throughout theservice region, is also a money-saver for “Patients say, ‘I don’t have to spend money on gas or anothe co-pay,’ ” said Dr. Kathleen chief of surgery for theDiablok region.
“Especially for elderly patients, it’es a big deal to go to the doctort and have a family member take off TheKaiser system’s shortage of however, is symptomatic of a national problem that could worsenh as baby boomers, thoswe born between 1946 and 1964, enter their 50s and 60s and theidr demand for services “We are seeing two separate said Dr. Jack Resneck, a dermatologist with the .
“Onr is that with the aging of the baby there are more skin cancers because the populatiojis aging, and older patientw are more likely to develop skin “The other issue is that the actual prevalence of skin cancersz — both melanoma and non-melanoma skin cancerss — has been increasing steadily over the last few The reasons for the shortage are from lack of training programs, which has resultef in just 300 new dermatologist s a year nationally for the past three decades, to the fact that dermatologyh tends to attract a lot of part-timee physicians with family responsibilities.
Also, the scope of practice has grown, with more doctors performinbg skin cancer surgeries as well ascosmetix dermatology. The average dermatologist spends 10 percent of the workdahy treatingcosmetic conditions, though a sub-set of them spendas 29 percent in that area, accordintg to a 2007 report by Resneckm and Dr. Alexa Boer Kimbal l of , published in the Journal of the . Kaisee Permanente didn’t provide details about the number of dermatologistsw it has inNorthern California. however, admit the system has long been plagued by a shortagee ofskin specialists.
The average wait for a dermatologist appointment in the United States is 33 to 36 according to Resneckand Kimball, thoughn that varies widely by Kaiser Sacramento Valley area spokesman Jeff Hausmamn said this region has 20 dermatologists and “coulr use” seven more, but doesn’t use the rovingy doctor plan. Some non-Kaiser doctors said the shortagee of dermatologists is inrural areas. “Myy hunch is that in the East Bay, there are enougg dermatologists to satisfy the neede ofthe population,” said Dr. Jeromew Potozkin, who has office in Walnut Creek and Danville and is president ofthe . “Ik think that the issue with Kaiserf would bemore Kaiser-specific.
” Oakland-based Kaiser, which runs the largest healtjh maintenance organization serving Greater previously experimented with a program that involvex nurses taking digital images of patients’ skin for review by a physician at a later time. It has sincd moved away from that effort, Ting because “patients want a dermatologist to look attheir skin.” the system has had more luck with recruiting though it still finds that assigning a rovin dermatologist every day helpsa them deal more efficiently with routine patientr concerns. “There are about half a thousanrdermatological diseases, but about eight of thesee diseases make up about 80 percent of the Ting said.
Kaiser doctors do perform cosmetivc services, but spokesman Jim Caroompas estimates thosse services accounted for only about 5 percen ofdermatology patients. “Wwe are doing cosmetics inside Kaiser, but it is easiere to get an appointment for a changing mole than acosmeticc procedure,” Ting said.